Provider Demographics
NPI:1235026378
Name:HOLT, MIKAILA GABRIELLE
Entity type:Individual
Prefix:
First Name:MIKAILA
Middle Name:GABRIELLE
Last Name:HOLT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:NE
Mailing Address - Zip Code:68025-5622
Mailing Address - Country:US
Mailing Address - Phone:531-235-6663
Mailing Address - Fax:
Practice Address - Street 1:3206 RAASCH DR STE 300
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-3175
Practice Address - Country:US
Practice Address - Phone:402-379-3888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-20
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider